Asthma and related MCQs by Dr chaitanya Joshi

Asthma lecture ppt Outline

Asthma inhaler MDI device
Asthma inhaler MDI device

Health exams preparation study tips health science Coaching syllabus wise MCQ test loksewa psc license free institute analog .
Table of contents (toc)

--Dr Chaitanya Joshi

Introduction of asthma

    Asthma is a Chronic inflammatory condition of airway Characterized by
    • 1. airway limitation: reversible

    • 2. airway hyperresponsiveness

    • 3. inflammation of bronchi T cell mediated, eosinophilic, hypertrophy, mucus plugging

Classification of asthma

Extrinsic asthma

  • Atopy (allergy)
  • Positive skin prick test
  • Childhood asthma a/w eczema

Intrinsic asthma

  • Middle age
  • No cause
  • May show positive skin prick test
  • External stimuli sensitization like toulene, NSAIDs,  beta blockers etc
  • Etiology and precipitating factors

Clinical features of asthma

  • Typical recurrent episodes with normal life in between
  • Wheezing
  • SOB
  • Chest tightness
  • Cough
  • Classical diurnal pattern with symptoms worse in morning and night
  • Cough and wheeze disturb sleep – nocturnal asthma

Diagnosis of asthma

  • Mostly clinical diagnosis
  • Symptoms improvement following bronchodilator and corticosteroid
  • Diurnal variation on 3 days a week for 2 weeks on PEF diary
  • PEF decrease after 6 min of exercise
  • Investigations 
  • PFT
  • Exercise test
  • Histamine or methacholine bronchial provocation test
  • Corticosteroids trial
  • Exhaled NO test
  • Blood and sputum workup
  • CXR
  • Skin prick test for allergen

Management of asthma- treatment of asthma

Symptoms control for asthma

  • Restore normal lifestyle
  • Reduce risk of recurrent and severe attacks
  • Enable normal growth and nutrition
  • Family education and counselling
  • Avoid under or overtreatment

Extrinsic factor control for asthma

  • Pet
  • Dust
  • Smoke
  • Medicine like NSAID, antibiotics
  • Allergens
  • Pollens 
  • Pharmacological treatment
  • Step down therapy
  • Once control established, dose of corticosteroid titrated to the lowest dose 

  • Decreasing dose of ICS around 25-50% every 3 months, a reasonable strategy for many

AE of asthma

  • Aka acute severe asthma
  • Treatment done at ER or on the way
  • Bronchodilators, nebulization, high dose steroids etc.
  • May even lead to death if not treated on time
  • Pack year calculation

Flapping tremor

  • Please refer to the slides

Fine tremor

  • Please refer to the slides

Drugs used for asthma

  • Please refer to the slides

Modified MRC scale of SOB

  • Please refe to the slides below

COPD types

Two classical phenotypes

  • Pink puffers: Thin, breathless and maintain a normal PaCO2 until the late stage of disease Emphysema, Compensated by hyperventilation, so ABG is normal

  • Blue bloaters: Hypercapnia> Early stage, Chronic bronchitis, Due to obstruction Co2 retention, may develop oedema and secondary polycythaemia

Barrel chest

Please refer to the slides

Multiple Choice Questions  related to respiratory system

What is asthma attack?

When the lungs is filled with water 
When airways tighten and the lungs don’t get enough air
When the heart beats too fast 
When the heart and lungs are working too hard 

Ans: b (When airways tighten and the lungs don’t get enough air)

2. Which of the following is not the characteristic of asthma? 

Increase in IgG immunoglobulins 
Airway hyperresponsiveness 
Infiltration of eosinophils into the airways 
Increased mucus production

Ans: a (Increase in IgG immunoglobulins)

3. The immediate response of asthma involves: 

Mast cell degranulation 
Binding of antigen to IgE on macrophages
Release of cytokines 
Activation of cholinergic nerves

Ans: a (Mast cell degranulation)

4.  Chronic asthma is associated with:  

Activation of T lymphocytes 
Reduced function of goblet cells 
Activation of eosinophils 
Decreased permeability of submucosal capillaries 

Ans: c (Activation of eosinophils)

5. Which test is NOT used during diagnosis of asthma? 

Diffusing capacity 
Peak expiratory flow rate 
Bronchodilator challenge test 
Skin prick test

Ans: a (Diffusing capacity)

6. A diagnosis of severe asthma should be made after about how many months of uncontrolled asthma?

1 month 
3-6 months 
6-9 months 
More than 9 months 

Ans: b (3-6 months)

7. When a patient is diagnoses with severe asthma, which of the following is recommended?

Referral to specialist 
Increased dosage of patient’s current medication 
Education about risk factors and triggers such as smoking
Treatment of comorbidities and triggers such as smoking

Ans: a (Referral to specialist)

8. Which drug is most commonly prescribed preventer therapy in asthma? 

Beta2 adrenoreceptor agonists 
Xanthine such as theophylline 
Muscarinic receptor antagonists
Inhaled steroids 

Ans: d (Inhaled steroids)

9. Once a patient is diagnosed with asthma and referred to specialist, what does GINA recommend next step? 

Referral to mental health professional 
Increased dosage of patient’s current medication 
Assessment of patient’s inflammatory phenotype 
Hospitalization for intense observation

Ans: c (Assessment of patient’s inflammatory phenotype)

10. Acute management of asthma include all of the following, EXCEPT: 

A high concentration of oxygen to achieve oxygen saturation of >90%
Short acting beta-2- agonists 
A slow infusion of aminophylline with monitoring blood values 
A rapid infusion of dopamine 

Ans: d (A rapid infusion of dopamine)

Thank you!

A doctor viewing x-ray of asthma patient
A doctor viewing x-ray of asthma patient

Thank you very much

Post a Comment

* Please Don't Spam Here. All the Comments are Reviewed by Admin.